Many of these changes are necessary due to increasing costs and lower profits, according to insurers.

But a new report from CNN finds the health insurance industry’s net income increased 46 percent, to $13.1 billion, in 2016.

Insurers did especially well in Medicare Advantage:

Where insurers did well was Medicare Advantage, where underwriting profitability soared 279%. Under Medicare Advantage, the federal government pays companies a fixed amount each month to cover Medicare-eligible Americans.

The increased profits come as consumers find themselves paying more for plans that cover less.